Tissue retrieval system

ABSTRACT

The tissue retrieval system deploys a tissue bag at the surgical site. The bag is supported by the system as tissue is placed within the bag and is closed to isolate the collected tissue and allow the bag and collected tissue to be removed from the body. The bag can be reopened and re-closed as desired through use of a guide bead and cord. The bead also facilitates removal of the collected tissue.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/275,636, filed May 12, 2014, entitled “TISSUE RETRIEVAL SYSTEM,”currently pending, which is a continuation of U.S. patent applicationSer. No. 11/549,971, filed Oct. 16, 2006, entitled “TISSUE RETRIEVALSYSTEM,” which issued as U.S. Pat. No. 8,721,658, which claims thebenefit of U.S. Provisional Application No. 60/726,821, filed Oct. 14,2005. The disclosures of each of these related applications are herebyincorporated by reference as if set forth in full herein.

BACKGROUND

This invention relates generally to apparatus and methods for capturingand retrieving tissue from body cavities and in particular to a specimenretrieval bag device.

Laparoscopic surgery is typically performed through trocars, whichprovide access across the abdominal wall and into the abdominal cavity.In some of surgeries, tissue disposed within the abdominal cavity is cutand removed from the body. However, removal of such tissue from the bodymay prove difficult due to the limited confines inherent withlaparoscopic surgery and the available laparoscopic surgicalinstruments. Also, such tissue may include an infected or cancerous massor organ, as well as blood, bile and other liquids, all referred toherein as tissue, which may pose infection issues or other complicationsif left within the body.

It is desirable to grasp, capture, retain and enclose this tissue whilein the body cavity, and then remove the enclosed tissue through thetrocar or incision. Containment of the tissue as quickly as possiblewith minimal disturbance to the surgical site is also desirable. Agenerally compact and single unit device would also prove desirable asdevices generally bulky and complicated have several shortcomings andlack optimal efficiency in particular with the limited space inoperating rooms and access ports in the body cavity.

SUMMARY

Generally, the present invention provides a tissue or specimen retrievaldevice. In one aspect, a tissue retrieval apparatus comprises anactuator and a tissue bag having an open end and a closed end. The openend of the tissue bag is connected to the actuator and a cord isattached along a periphery of the open end of the tissue bag and to theactuator. A guide bead frictionally coupled to the cord.

In one aspect, a tissue retrieval apparatus comprises an actuation rodmovable in a proximal and a distal direction. A tissue bag is connectedto the actuation rod and is movable from a stored position to a deployedposition. A ratchet is connected to the actuation rod and is movablebetween a first and a second position. The ratchet in the first positionis arranged to allow the bag to be moved from the stored position to thedeployed position as the actuation rod is moved in the distal directionand restrict movement of the actuation rod in the proximal direction.The ratchet in the second position is arranged to allow the actuationrod to move in the proximal direction and restrict movement of theactuation rod in the distal direction.

In one aspect, a tissue retrieval apparatus comprises an introducer tubehaving a longitudinally extending lumen and a movable actuator having aproximal and a distal end and connected to the introducer tube andmovable through the lumen of the introducer tube. The distal end of theactuator has at least one support arm and the proximal end of theactuator has a handle. A tissue bag has an open end and a closed endwith the open end coupled to the at least one support arm. A cordattaches to the open end of the tissue bag and the movable actuator. Thecord is a continuous closed loop.

In one aspect, a tissue retrieval apparatus comprises a cord, a tissuebag having an open end and a closed end with the open end attached tothe cord; and a guide bead frictionally connected to the cord. In oneaspect, a tissue retrieval apparatus comprises a cord and a tissue baghaving an open end, a closed end and a superabsorbent polymer with theopen end attached to the cord.

In one aspect, a tissue retrieval apparatus comprises an introducer tubehaving a longitudinally extending lumen with a handle assembly extendingfrom one end of the introducer tube. The handle assembly has a pair offinger loops. The apparatus further comprises an actuation rod with aproximal and a distal end and is movable through the lumen and thedistal end has a plurality of support arms and the proximal end has ahandle. A tissue bag has an open end and a closed end with the open endreleasably coupled to the support arms and having a continuous cord loopattached to the open end of the tissue bag and being releasably attachedto the movable actuation rod. The apparatus further comprises a guidebead being substantially cylindrical with a bore and the cord loopextending through the bore and a pawl having at least one tooth and arack having a plurality of teeth operationally engaging with the atleast one tooth of the pawl. The rack is attached to the actuation rodand the pawl is pivotally attached to the handle assembly.

Many of the attendant features of the present invention will be morereadily appreciated as the same becomes better understood by referenceto the foregoing and following description and considered in connectionwith the accompanying drawings in which like reference symbols designatelike parts throughout.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a tissue retrieval system in anon-deployed condition in accordance with various aspects of the presentinvention;

FIG. 2 is a perspective view of a tissue retrieval system positionedthrough an access port and a body wall in accordance with variousaspects of the present invention;

FIG. 3 is a perspective view of a tissue retrieval system in a deployedcondition in accordance with various aspects of the present invention;

FIG. 4 is a perspective view of a tissue retrieval system with aspecimen bag closed and the system positioned through an access port anda body wall in accordance with various aspects of the present invention;

FIG. 5 is a perspective view of a tissue retrieval system with aspecimen bag closed and the system positioned through an access port anda body wall with a cord loop detached in accordance with various aspectsof the present invention;

FIG. 6 is a perspective view of a tissue retrieval system with theremoval of an introducer and actuation assembly in accordance withvarious aspects of the present invention;

FIG. 7 is a perspective view of a specimen retrieval bag with a cordloop through a body wall in accordance with various aspects of thepresent invention;

FIG. 8 is a side view of a specimen bag in accordance with variousaspects of the present invention;

FIG. 9 is a side view of a specimen bag in accordance with variousaspects of the present invention;

FIG. 10 is a cross-sectional side view of a portion of the tissueretrieval system with a ratchet having a pawl positioned with a specimenbag being or about to be deployed in accordance with various aspects ofthe present invention;

FIG. 11 is a cross-sectional side view of a portion of the tissueretrieval system with a ratchet having a pawl positioned in a neutralposition after deployment of a specimen bag in accordance with variousaspects of the present invention;

FIG. 12 is a cross-sectional side view of a portion of the tissueretrieval system with a ratchet having a pawl positioned with a specimenbag being or about to be closed in accordance with various aspects ofthe present invention;

FIG. 13 is a perspective view of a specimen retrieval bag with a cordloop through a body wall in accordance with various aspects of thepresent invention;

FIG. 14 is a cross-sectional top view of a distal portion of the tissueretrieval system in accordance with various aspects of the presentinvention;

FIG. 15 is a side view of a bead in accordance with various aspects ofthe present invention;

FIG. 16 is a cross-sectional front view of a bead in accordance withvarious aspects of the present invention;

FIG. 17 is a cross-sectional side view of a bead in accordance withvarious aspects of the present invention;

FIG. 18 is a top view of a distal portion of the tissue retrieval systemin accordance with various aspects of the present invention;

FIG. 19 is a side view of a bead in accordance with various aspects ofthe present invention;

FIG. 20 is a side view of a bead in accordance with various aspects ofthe present invention;

FIG. 21 is a cross-sectional top view of a distal portion of the tissueretrieval system in accordance with various aspects of the presentinvention;

FIG. 22 is a top view of a distal portion of the tissue retrieval systemin accordance with various aspects of the present invention;

FIGS. 23-25 are cross-sectional top views of a distal portion of thetissue retrieval system in accordance with various aspects of thepresent invention; and

FIG. 26 is a perspective view of a bead in accordance with variousaspects of the present invention.

DETAILED DESCRIPTION

In this description, “proximal” or “proximally” refers to that portionof the instrument, component, or element that extends toward the user.“Distal” or “distally” refers to that portion of the instrument,component, or element that extends away from the user. In FIG. 1, atissue retrieval device in a non-deployed or non-activated initialcondition is shown. The tissue retrieval device is arranged to containand withdraw excised tissue specimens from within a body cavity. Thetissue retrieval device has an introducer 3 and an actuator or actuationrod 7. The introducer 3 in one aspect has a tubular configuration with ahollow lumen and a handle assembly 5 extending from a proximal end ofthe introducer. The handle assembly has a pair of finger loops or gripsutilized to hold or stabilize the introducer as desired. The proximalend and/or the distal end of the introducer 3 in one aspect aregenerally open. The actuator rod 7 in one aspect has a handle 9extending from a proximal end of the actuator rod 7. The handle 9provides a graspable portion of the device to control or facilitatemovement of the actuator rod relative to the introducer 3.

Referring now to FIG. 2, operationally, an access device 8, such as atrocar, is first placed through a body wall 4 leaving an access conduit,e.g., the trocar cannula 8 b, disposed across the body wall. Using thehandle assembly 5 to maneuver the introducer 3, the tissue retrievaldevice is inserted into the conduit, e.g., through the trocar cannula 8b and/or a seal housing 8 c attached to or included with the trocarcannula, until a distal end 3 a of an introducer tube 3 extends beyond adistal end 8 a of the trocar cannula 8 b.

In FIG. 3, movement of the actuator rod 7 relative to the introducertube 3 activates the deployment of a specimen bag 21, which is arrangedas a receptacle for tissue specimens. In particular, the specimen bag 21is deployed out from the introducer tube 3 and into the body cavity bypushing the actuation rod 7 in a distal direction as shown by arrow 6.Extended into the body cavity, the specimen bag 21 is suspended and heldopen by two support arms 23 a,b extending from the actuation rod 7. Eachsupport arm is attached to or integrated with the actuation rod 7. Thespecimen or tissue bag has an open end 21 a, through which tissuespecimens are inserted, to rest in a closed end 21 b of the specimenbag. In one aspect, the specimen bag is a polyurethane specimen bag.

Once a tissue specimen, such as a gallbladder or portions thereof, isseparated from the adjoining vessels and structures, it is placed intothe specimen bag 21. After insertion of the tissue specimens into thespecimen bag 21, the specimen bag 21 in one aspect is closed to preventspillage of its contents and to prevent contamination of the body cavitywall and/or other tissue in the body cavity during withdrawal of thetissue specimen from within the body cavity. Referring to FIG. 4, theactuation rod 7 is retracted proximally to withdraw the support arms 23a,b from the specimen bag 21 without disrupting or disturbing the bag orthe contents within the bag. In one aspect, the support arms 23 a,b arepulled out of or from the specimen bag and tension is applied to a cordloop 25 to cinch the bag 21 closed. In one aspect, a bead 31 is attachedto the cord loop 25 engaging the bag 21 to assist in closing the bag 21.The guide bead is made of a material, e.g., polycarbonate, which isdifferent from the material of the cord loop, e.g., nitinol. As such,the guide bead is less resilient than the cord and thereby provides andfacilitates withdrawal of the bag, manipulation of the bag andopening/re-opening and closing/re-closing of the bag as discussed ingreater detail below. Once the specimen bag is fully closed, a smallloop end or portion 25 a of the cord is exposed on the actuation rod 7near the proximal end of the introducer 3 or handle assembly 5.

Referring now to FIG. 5, at this stage, the specimen bag 21 can becompletely detached and removed from the actuation rod 7 and introducer3 by lifting the cord loop 25 from a retaining slot 7 a on the actuationrod 7. In one aspect, the cord loop is a cord forming or formed into acontinuous closed loop. The movable actuator or actuation rod 7 in oneaspect has a retaining slot 7 a located adjacent to the proximal end ofthe movable actuator and is arranged to frictionally hold the cord loop25. In FIG. 6, the tissue retrieval device is withdrawn leaving behindthe specimen bag 21 with the cord 25 extending through the trocar 8. Asshown in FIG. 7, to protect the trocar seal and the integrity of the bagand its contents, the trocar 8 can also be withdrawn from the body wall4 leaving the specimen bag in the body cavity and the cord loop 25disposed across the body wall. The specimen bag 21 can be completelywithdrawn from the body cavity. In some cases, a portion of the bag, forexample, the neck of the specimen bag is withdrawn through the bodywall. Once the neck of the specimen bag has traversed the body wall, thespecimen bag is then reopened. The reopened specimen bag can then beaccessed to remove or compact its contents to aid with completewithdrawal from the body cavity using an open or endoscopicinstrumentation such as forceps, graspers, and aspiration probes. Withthe bulk of the contents removed or reduced, the specimen bag isre-closed. The cord loop 25 is pulled in a proximal direction tocompletely withdraw the specimen bag 21 from the body cavity. In oneaspect, the bead 31 facilitates the re-opening, re-closing and/orwithdrawal of the bag or portion thereof from the body cavity.

In some cases, withdrawal of the specimen bag 21 from within the bodycavity can be used for small tissue specimens placed in the specimenbag, which are not likely aspirated, compacted, or removed from thespecimen bag 21 prior to withdrawal of the specimen bag through the bodywall. In this case, the cord loop 25 can be left attached to theactuation rod 7 and the tissue retrieval device along with the trocarcan be simultaneously withdrawn from the body cavity and through thebody wall.

In FIG. 8, one aspect of a specimen bag is shown with the introducer 3and actuation rod 7 hidden for easier visibility of the specimen bag andassociated components. The specimen bag 21 has an open end 21 a and aclosed end 21 b. Tissue collected is deposited through the open end andinto the closed end of the specimen bag. The open end has a cuff thatoutlines all or a portion of the perimeter or periphery of the open end.The cuff defines a channel or channels arranged to receive the supportarms 23 a,b. In one aspect, a continuous channel is provided extendingalong the edge of the open end of the specimen bag with the cord 25disposed in the channel and each support arm 23 a,b insertable andremovable therefrom. In one aspect, multiple channels are provided toreleasably receive the support arms. For example, two channels areprovided, each on opposing sides of the specimen bag and each channel isarranged to receive one of the support arms. As such, the channel issized and dimensioned to slidably receive the support arms 23 a,b and inparticular, the channel or channels allow the support arms to easilyretract out from the cuff or edge of the specimen bag as the actuationrod 7 is moved in the proximal direction. During assembly of the deviceor at least prior to use, the support arms are placed within the cuff ofthe specimen bag. The specimen bag and support arms in one aspect arelightly compressed, slightly adhered or frictionally mated together toensure attachment of the specimen bag to the support arms 23 a,b. Theattachment is overcome by the support arms 23 a,b being retracted intothe introducer 3 as the support arms slide out of the cuff of thespecimen bag.

The open end of the specimen bag is also attached to the cord loop 25.In one aspect, the cuff 51 confines the cord loop as the cord loopencompasses the perimeter of the open end of the specimen bag. The cuff51 in one aspect also has a continuous channel included or integral witha channel arranged to receive the support arms and to hold the cord loop25. In one aspect, a separate and/or adjacent channel to hold the cordloop 25 separately from the support arms 23 a,b is provided. The cuffportion holding the cord loop may be reinforced for example byadditional or stronger material than the remaining specimen bag tocounteract tension or force applied to the cord loop during manipulationor closure of the bag and to avoid unintended separation of the bag fromthe cord loop. Likewise, the cuff portion holding the support arms maybe reinforced for example by additional or stronger material than theremaining specimen bag to counteract forces applied by the support armsduring manipulation of the device, to assist in opening the bag, tostrengthen the support of the bag with the weight of tissue in the bag,to facilitate placement of tissue in the bag and to avoid unintendedseparation of the bag from the support arms. In one aspect, interactionwith the cuff and/or channel of the specimen bag with the bead 31 canalso assist in closing, reopening or reclosing of the specimen bag.

In one aspect, the inside surface of the specimen bag 21 is lined with aliquid absorbent material to absorb liquids such as bile to preventinadvertent spillage of the fluid from the specimen bag. The liquidabsorbent can be formed from cotton or a superabsorbant polymer. Asuperabsorbant polymer material is used in one aspect to initially bindthe body fluid into a gel matrix to prevent spillage of the fluid duringusage and manipulation within a body cavity. The gel can then beaspirated out of the specimen bag with a laparoscopic irrigationaspiration device to reduce the volume of the specimen bag prior towithdrawal from the body cavity. In one aspect, superabsorbant polymeris dispersed through the inside of the bag to spread the absorbed tissueor fluid evenly throughout the bag. In one aspect, the superabsorbantpolymer is integrated into portions, placed into releasable or permeablepockets, coated or layered throughout or in select locations in the bag

In FIG. 9, the tissue retrieval system in one aspect comprises a thirdarm 61 to enhance or facilitate the deployment of the specimen bag 21.The third arm 61 in one aspect is a spring arm positioned between oradjacent to the support arms 23 a,b extending from the actuation rod 7such that it would force the specimen bag 21 to unroll downward duringdeployment of the specimen bag. The third arm 61 withdraws from thespecimen bag during the closing of the specimen bag and/or retraction ofthe support arms or movement of the actuation rod 7 in the proximaldirection. As such, a first, second and third support arm, 23 a,b and61, all extend from the actuator 7 and through the guide bead 31. Thethird arm 61 is movable in a direction traverse to the first and secondarms 23 a,b. The third arm 61 in one aspect is substantially shorterthan the first and second arms 23 a,b.

Referring now to FIGS. 10-12, the actuation rod 7 and handle assembly 5of introducer 3 in one aspect comprises a ratchet, which allows distalmovement of the actuation rod 7 and prevents the actuation rod frombeing pulled in a proximal direction during deployment of the specimenbag. The ratchet ensures effective deployment and closure of thespecimen bag. In one aspect, the ratchet comprises a pawl 41 with atleast one tooth pivotally attached to a pivot pin on the handle assembly5. The pawl operationally engages a rack 45 extending longitudinallyalong the actuation rod 7. In one aspect, the pawl has three teeth and aU-shaped leaf spring 43 is coupled to the pawl and biases the pawltowards a neutral position. The neutral position for the pawl 41 is theposition where the central pawl tooth is generally perpendicular to thelongitudinal axis of the rack 45.

The rack 45, in one aspect, has a plurality of teeth and is integral toor otherwise attached to the actuation rod 7. The pawl 41 and leafspring 43 are nested in the handle 5 of the introducer tube 3. As such,in one aspect, the pawl 41 is pivotally connected to the handle assembly5 of the introducer 3 and the actuation rod 7 is connected to theintroducer and movable through the introducer 3. During assembly of thetissue retrieval device, the pawl 41 is initially positioned such thatit is rotated clockwise from the neutral six o'clock position (FIG. 10).As such, if one tries to move the actuation rod 7 in a proximaldirection, the teeth on the pawl rotate counter-clockwise and bind intothe teeth on the rack of the actuation rod to prevent proximal movementof the actuation rod 7. When the actuation rod 7 is moved in the distaldirection, as shown by arrow 6, the pawl teeth do not bind against therack teeth and therefore the actuation rod is free to move in the distaldirection. As such, the ratchet in one aspect comprises a pawl 41 havinga tooth and a rack 45 having a plurality of teeth operationally engagingwith the tooth of the pawl 41. The rack 45 is attached to the actuationrod 7. In one aspect, the ratchet provides or comprises means forregulating movement of the actuator or actuation rod 7.

Operationally, the actuation rod 7 is first pushed in the distaldirection until the specimen bag 21 is fully extended and deployedoutside of the distal end of the introducer 3. The ratchet preventsinadvertent and/or unexpected movement of the actuation rod 7 in theproximal direction, which may prematurely retract a partially deployedspecimen bag. For example, if the actuation rod was moved in theproximal direction during the specimen bag deployment, the support arms23 a,b could be fully or partially removed from the specimen bag 21.During subsequent movement of the actuation rod in a distal direction,the support arms might not realign with cuffs on the specimen bag andcould be pushed through the specimen bag or not support the specimenbag.

Upon full deployment of the specimen bag 21, the pawl 41 rides down orinto a ramp 47 on the rack 45, which allows the pawl to move to theneutral position (FIG. 11). As such, the ratchet is movable to a thirdor neutral position. With the ratchet being in the third position, thepawl 41 is substantially perpendicular to the rack 45. After thespecimen is collected in the specimen bag 21, the actuation rod 7 ismoved in the proximal direction, as shown by arrow 10. The pawl 41 ridesup the ramp 47 on the rack 45 causing the pawl to be positioned suchthat it is rotated counter-clockwise from the neutral position (FIG.12). If the actuation rod 7 is moved in a distal direction, the teeth onthe pawl 41 rotate clockwise and bind into the teeth on the rack 45 toprevent distal movement of the actuation rod 7. When the actuation rodis moved in a proximal direction, the pawl teeth do not bind against therack teeth and therefore the actuation rod is free to move in theproximal direction. The actuation rod 7 is moved proximally until in oneaspect the specimen bag is fully closed and/or the support arms arefully withdrawn from the bag. In one aspect, the specimen bag is notclosed until the support arms are fully withdrawn from the bag. Once thespecimen bag 21 is completely closed and/or the support arms are fullywithdrawn from the bag, the actuation rod in one aspect engages a stopon the handle 5 of the introducer 3 that locks or restricts furthermovement of the actuation rod 7 in one or both directions. As such, thestop in one aspect provides or comprises means for preventing themovable actuator from being fully withdrawn from the lumen.

The ratchet in one aspect ensures that during closure of the specimenbag 21 complete incremental closure of the bag and/or withdrawal of thesupport arms from the specimen bag are achieved. For example, byensuring one way directional movement of the actuation rod 7, thesupport arms 23 a,b of the actuation rod 7 may not be partiallywithdrawn from the specimen bag and then reinserted into the specimenbag 21. If, for example, the support arms are withdrawn and reinsertedbut are not aligned with the cuffs of the bag, the support arms 23 a,bmay be pushed through the specimen bag or not properly support thespecimen bag. The ratchet 40 also prevents reinsertion of the supportarms 23 into the body cavity after the specimen bag 21 has been detachedfrom the device. Reinsertion of the support arms 23 a,b into the bodycould decrease visibility within the body cavity and the support arms 23a,b could become entangled with the cord loop 25 or could becomeentangled with another device in the body cavity. The ratchet 40 alsoallows that if the tissue specimens are not voluminous, the cord loop 25of the specimen bag 21 can be left attached to the actuation rod 7 andthe tissue retrieval device along with the trocar seal and cannula canbe withdrawn from the body cavity and through the body wall. The ratchetensures that tension is maintained on the cord loop 25 and prevents theactuation rod from being pulled back into the introducer 3 as the deviceis withdrawn from the body cavity and through the body wall. If theintroducer tube 3 alone is manually grasped during withdrawal of thedevice from the body cavity, an axial tensile force is naturally appliedto the bead, the specimen bag, and the actuation rod by the body wall.The ratchet counteracts this tensile force to prevent movement of theactuation rod, bead, and specimen bag in the distal direction relativeto the distal tip of the introducer tube.

The tissue retrieval device in one aspect has a loop of cord 25 attachedto the specimen bag 21 and is held in place by or in a retaining slot 7a on the actuation rod 7. Once the tissue specimen is collected in thespecimen bag 21 and the specimen bag closed by moving the actuation rodin the proximal direction, the cord loop 25 and retaining slot 7 a isexposed on the actuation rod 7. To release the loop from the retainingslot, the cord loop can be grasped and pulled from the slot. Thespecimen bag 21 with the cord loop 25 is detached from the support arms23 of the actuation rod 7. As such, the tissue retrieval device and thetrocar cannula and/or seal can be moved in a proximal direction leavingthe cord loop 25 behind, e.g., partially disposed through the body walland partially external to the body cavity. The cord loop 25 may bewithdrawn separately along with the specimen bag 21 and its contentsfrom the body cavity and through the body wall. The cord 25 in oneaspect comprises braided monofilament nylon fibers with a braideddiameter of 0.025″ and tensile strength of 30 lbs. The cord loop 25enables the surgeon to easily and quickly use the cord to effectwithdrawal of the specimen bag 21. The cord loop 25 also allows anapplication of significant axial tensile force to the cord whilemaintaining retention of the cord, e.g., allowing the user's finger tohook onto the cord loop 25. For example, a single strand of cord couldbe attached to the specimen bag. However, securing and retaining hold ofa single strand of cord by hand can be difficult. In some instances, auser may use a grasping instrument to withdraw the cord but that cancompromise the integrity of the cord.

In one aspect, the cord loop 25 also enables a large tensile force, ifdesired, to be applied to the specimen bag 21 during withdrawal of thespecimen bag from a body cavity and through a body wall. Duringwithdrawal of the specimen bag 21, a tensile force is applied by thehand of the surgeon at the proximal end of the loop 25. This tensileforce is equally divided into the two strands of the loop 25 such thatonly half of the tensile force is applied to each strand of the cordloop. For example, if a 20-pound tensile force is applied by the surgeonto the cord loop 25 in an effort to withdraw the specimen bag 21 from abody cavity, the tensile force in each strand of the cord loop is 10pounds. In comparison, using only a single strand cord attached to thespecimen bag, when, for example, a 20 pound tensile force is applied bya user to a single strand cord, the tensile force in the strand cord is20 pounds. The cord loop 25 as compared to a single strand cord reducesthe likelihood that the specimen bag 21 can separate from the cord loopduring for example withdrawal of the specimen bag from the body cavity.As such, the cord loop 25 provides an increased strength for withdrawalof a specimen bag from a body cavity.

The cord loop in one aspect can be quickly and easily released from theactuation rod 7 to detach the specimen bag 21 from the tissue retrievaldevice. The cord loop 25 is nested into a retaining slot 7 a towards theproximal end of the actuation rod. The retaining slot is sized such thatit is smaller than the diameter of the cord. The retaining slot 7 a inone aspect has a relief area that allows the cord to slide while a slotinterference serves to retain the cord and prevent the cord fromslipping out of the slot. In one aspect, the slot interference isdisposed in the actuation rod 7 generally perpendicular to thelongitudinal axis of the actuation rod. In one aspect, two parallelwalls in the actuation rod 7 extending perpendicular to the longitudinalaxis of the actuation rod define the slot interference. A projection ordetent extends in the longitudinal direction of the actuation rod 7 orgenerally traverse to the parallel walls from the distal parallel wall.The detent holds or catches the cord loop 25 securing or capturing theloop within the retaining slot 7 a.

In one aspect, the cord 25 is not accessible until the actuation rod 7is sufficiently withdrawn from the introducer 3 and/or the support arms23 a,b are removed from the bag 21. This prevents the bag 21 from beingpotentially damaged by the support arms if the bag is closed with thesupport arms in the bag. A portion of the cord loop is wound, looped orcoiled within the introducer 3 to take up the travel distance of theactuation rod 7 relative to the introducer 3 to thereby only allow thedesired timing to expose the cord for accessing by a user. A reliefslot, in one aspect, is disposed near the distal end of the rodextending through the rod and having a generally rectangular shape. Theexcess cord is disposed through the slot and into a longitudinallyextending travel slot on an opposing side of the rod opposite the sidealong which the cord lies on the rod from the bag to the holding slot 7a. These slots assist in preventing binding of the excess cord on therod 7 or introducer 3 as the rod 7 is moved. As such, in one aspect, anexcess length of the continuous closed loop cord 25 is looped in betweenthe movable actuator or actuation rod 7 and the introducer tube 3. Inone aspect, the cord lies or sits in a longitudinally extending travelslot along the rod 7 extending from near the distal end of the rod 7 tothe retaining slot 7 a. The travel slot also assists in preventingbinding of the cord on the rod 7 or introducer 3 as the rod 7 is moved.

To release the cord 25 from the actuation rod 7, the cord is taken outof the slot 7 a of the actuation rod 7. The tissue retrieval device canbe removed from within the body cavity and through the body wall leavingthe specimen bag 21 in the body cavity and the cord loop 25 disposedacross the body wall. As such, cumbersome and expensive cutting elementsincluded with the device or separately provided in which the surgeoncuts the cord in order to release the specimen bag from the device canbe avoided. Also, other cumbersome and time consuming activitiesperformed by the surgeon such as pulling on a small single strand cordto untie a slip knot to release the specimen bag from the device canfurther be avoided.

The cord loop 25 during manufacture of the tissue retrieval system canbe easily attached to the retaining or holding slot 7 a by sliding thecord loop through the holding slot, thereby cumbersome and timeconsuming manufacturing procedures are avoided. For example, a slip knotto secure a single strand cord to an actuation rod would causeproduction personnel to laboriously tie a knot at the proximal end ofthe cord during assembly of the device resulting in among other thingsan increased assembly cost for the system. In another example, a cordthreaded through a pull ring with a retention knot would causeproduction personnel to laboriously tie a knot at the proximal end ofthe cord during assembly of the device resulting in an increasedassembly cost for the system. In one aspect, the cord loop 25 isultrasonically welded, bonded or mechanically crimped together and thusthe cord forms a continuous closed loop.

Referring now to FIGS. 13-14, in one aspect, the cord loop 25 comprisesa handle 27 or gripping member attached to the cord loop to aid withwithdrawal of the specimen bag. The gripping member can be formed froman elastomeric tube such that the cord is threaded through the tube. Thegripping member or handle can also be positioned towards the distal tipof the actuation rod 7 such that the cord 25 slides through theintroducer to enable cinching of the specimen bag. Upon detachment ofthe cord loop 25 from the actuation rod 7, the cord slides through theintroducer until the proximal end of the cord loop 25 pulls theintroducer from the actuation rod thereby exposing the gripping handleon the proximal end of the cord loop. As such, a gripping member orhandle 27 is connected to the cord loop 25 and is movable within thelumen of the introducer tube 3. The gripping handle 27 in one aspect issubstantially tubular with a lumen having a diameter corresponding to adiameter of the cord.

Referring now to FIGS. 15-17, the tissue retrieval device, in oneaspect, comprises a bead 31 coupled to the cord loop 25. The guide beadin one aspect is substantially cylindrical. The bead has a hole or bore39 centered along its longitudinal axis through which the cord loop 25traverses. The hole 39 is sized such that the bore frictionally engagesthe cord 25 to retain the specimen bag 21 in a closed configuration oncethe specimen bag 21 has been closed. At least one support arm extendsfrom the actuator and through the guide bead. The guide bead in oneaspect has at least one slot 38 is adjacent to the bore 39 through whichthe at least one support arm extends through. As such, the at least onesupport arm 23 a or 23 b extends from the actuator and through the guidebead 31. When the specimen bag 21 is detached from the device leavingthe specimen bag 21 in the body cavity with the cord loop 25 disposedthrough the body wall, the cord loop 25 can be withdrawn until the bead31 and a partial portion of the specimen bag, e.g., the cuff portion ofthe specimen bag, are exterior to the body wall while the collectedspecimen is still positioned in the body cavity.

The specimen bag 21 can be reopened by moving the distal end of thespecimen bag rim and the bead 31 in opposite directions of each other.The contents of the specimen bag 21 can be accessed while the specimenbag lines and protects the body wall from contamination. For example,the specimen bag 21 can be accessed with an aspiration device to removecollected fluids such as bile from the gallbladder to reduce the volumeof the specimen bag contents. By reducing the volume of the contents ofthe specimen bag, the specimen bag can be completely withdrawn throughthe body wall without enlarging the opening in the body wall.

In another example, if the contents of the specimen bag 21 include alarge number of gallstones, the gallstones can be accessed with alaparoscopic grasper or forceps and removed one by one to reduce thevolume of the specimen bag contents to facilitate withdrawal of theremainder of the specimen bag 21 through the body wall. Likewise, thespecimen bag 21 can be reopened to place additional gallstones with alaparoscopic grasper or forceps and then reclosed with the grasper orwith the assistance of the grasper or by pulling the cord loop whichautomatically recloses the specimen bag 21 as the bead 31 enters theincision site. With all the blood, irrigation and tissue debris at thesurgical site, it may be difficult to find spilled stones, so by firstclosing the bag and isolating the contents, irrigation and suction canbe introduced to clear the site for better visibility of the material tobe removed. The surgeon may have to introduce a large graspinginstrument to get a secure grip on the stone and pull it through thetrocar cannula 8 b. However if the stone is large, the jaws of thegrasper may not completely close and thereby may not fit through thetrocar cannula. Forcing the jaws closed may push the stone out of thejaws or crush it into particulate potentially dropping infected contentsback into the abdomen.

The specimen bag 21 can also be closed prior to its complete withdrawalfrom the body cavity by pulling the bead 31 and the cord loop 25 inopposite directions until the specimen bag 21 is cinched closed.Likewise by reversing the operation, the specimen bag can be reopened.As such, the guide bead 31 is movable from a first position to close thetissue bag 21 to a second position to open the tissue bag 21. Byallowing the bag 21 to be closed and reopened as desired throughinteraction of the bead 31 and the cord loop 25, multiple timeconsuming, cumbersome and potentially undesirable operations are reducedor eliminated. For example, a knot or a noose on the cord utilized toretain a specimen bag in a closed configuration does not allow thespecimen bag to be easily reopened and a surgeon will typically cut offthe rim portion of the specimen bag to gain access to the contents ofthe specimen bag prior to withdrawal from the body cavity. As the rim iscut off, the cord is also removed. The surgeon then attaches clampsaround the opening of the specimen bag to secure the specimen bag and toprevent it from retracting back into the body cavity. With the cord andrim of the specimen bag removed, the clamp is used to close the bagafter additional tissue is added and subsequently withdraw the specimenbag out of the body cavity. If the bag is to be reopened again, itbecomes difficult to reposition the clamp to both secure and open thebag and also to close and withdraw the bag out of the body cavity. Also,with the rim of the bag removed, the volume available in the bag toaccommodate tissue and the area available to grasp and manipulate thebag are substantially reduced.

The bead 31, being generally cylindrical for example, in one aspect alsoserves to facilitate withdrawal of the specimen bag 21 through the bodywall by acting as a dilator and guide. If a dilating or separatingtrocar, for example, is first used to traverse a body wall such as theabdominal wall to create an access site for insertion of a tissueretrieval system, the opening in the body wall can be minimal in size,making withdrawal of a specimen bag 21 difficult. When the specimen bag21 is detached from the device with the cord loop 25 left disposedthrough the body wall, as the cord loop 25 is pulled away from the bodywall, the bead 31 is pulled into the body wall and acts to dilate theopening, conduit and/or access channel and/or separate the muscle andtissue fibers of the body wall. The bead 31 in one aspect is shaped suchthat a dilating tip 33 or the leading portion (relative to moving out ofthe body) includes a blunt and tapered end 33 a to enable the separationof the muscle and tissue fibers. In one aspect, the guide bead issubstantially cylindrical having a sloped proximal end. As the bead 31traverses the body wall, the cinched rim of the bag 21 and the remainderof the bag can easily follow with the bead 31 leading the way and thecinched rim of the bag 21 gathered in-line behind the bead 31. Thus, thebead 31 avoids the reliance on the bunched and closed rim of thespecimen bag 21 to force its way through the body wall during withdrawalof the specimen bag 21. Without the bead 31 leading the way, the bunchedrim of tissue bag and/or the cord may catch on the body duringwithdrawal of the specimen bag through the body wall.

The bead 31 also in one aspect is configured to prevent the specimen bag21 from being pulled into the central bore 39 in the bead 31, whichfrictionally engages the cord loop 25. For example, in one aspect, thedepth of the cord engagement bore 39 or central bore of the bead 31through which the cord loop 25 runs extends from the proximal end of thebead 31 for approximately 0.125″ while the overall length of the bead isapproximately 0.530″. The distal portion of the bead is hollowed out toprovide space, a hollow space 36, allowing the specimen bag 21 to bepartially pulled into during cinching of the specimen bag 21. Thecentral bore 39 on the bead 31 which frictionally engages the cord loop25 is approximately 0.035″ in diameter and is positioned a sufficientaxial distance from the distal end of the bead such that when thespecimen bag 21 is cinched closed, the specimen bag 21 is not pulledinto the central bore 39 in the bead 31. This spacing between thecentral bore 39 and the distal end of the bead 31 prevents the specimenbag 21 from being pulled into the bore and becoming wedged between thecord loop 25 and the central bore 39. If the specimen bag 21 is allowedto be pulled into the central bore 39 of the bead 31 during closure ofthe specimen bag 21, the specimen bag 21 could become wedged between thecentral bore 39 and the cord loop 25 and could prevent further movementof the cord loop 25 and thus closure of the specimen bag 21. In oneaspect, the introducer 3 has a longitudinally extending lumen with afirst diameter and the actuator 7 is movable through the lumen. Theguide bead 31 has a second diameter substantially equal to the firstdiameter of the introducer 3.

The bead 31 also in one aspect enables or facilitates the closure of thespecimen bag 21. For example, the bead 31 in one aspect has a radialgroove 32 in which a retaining ring 35 is disposed. The retaining ring35 as such in one aspect encircles a portion of the guide bead 31. Theretaining ring 35 in one aspect is made of tempered stainless steel witha circular cross-section. The retaining ring 35 is configured such thatit can expand and compress. In one aspect, the retaining ring 35 is“C-shaped” or has a radial gap cut through the ring to facilitateexpansion and compression of the ring 35. The retaining ring 35 ispositioned onto the bead 31 such that the retaining ring does not movelongitudinally along the axis of the bead and/or out of a groove 32disposed partially or completely around the periphery of the bead.

During assembly of the device and/or prior to use, the specimen bag 21with the affixed bead can be pre-rolled and stored in the introducer 3.In this state, the retaining ring 35 is compressed by the introducer 3which has an inside diameter that is smaller than the non-compresseddiameter of the retaining ring 35. Upon deployment of the specimen bag21 from the introducer 3, the bead 31 and the retaining ring 35 alsodeploy out of the distal end of the introducer 3. Once the bead 31 withthe retaining ring 35 is deployed out of the introducer 3, the retainingring 35 expands, e.g., to its original or approximately pre-compresseddiameter. The retaining ring 35 prevents the bead 31 from being entirelypulled or withdrawn proximally into the introducer 3. For example, asthe specimen bag 21 is closed via application of an axial tensile forceon the cord loop 25, the retaining ring 35 limits the bead 31 fromsliding or otherwise being withdrawn into the introducer 3 and therebyprevents the specimen bag rim or cuff from also being pulled into theintroducer 3. The introducer tube 3 in one aspect has a longitudinallyextending lumen with an inner diameter that generally corresponds or issubstantially equal to the outer diameter of the guide bead and therebywith the retaining ring 35 is limited from moving back into theintroducer 3. As such, the guide bead 31 in one aspect provides a meansfor frictionally engaging the cord loop and in one aspect is arranged tomove out of the lumen of the introducer and restricted from moving backinto introducer.

As shown in FIG. 17, the bead 31 in one aspect comprises of twocomponents 34 a, 37 a to couple the bead 31 to the specimen bag 21. Thefirst bead component 34 a comprises a dilating portion 34 b at itsproximal end and a cylindrical tubular portion 34 c at its distal end.The second bead component 37 a comprises a capture ring designed toslide over the cylindrical portion 34 c of the first bead component 34a. The second bead component or capture ring 37 a has an annular snapfit 37 c to engage and lock onto the cylindrical portion 34 c of thefirst bead component 34 a. The specimen bag 21 in one aspect has atubular portion or an extended cuff channel to slide over thecylindrical portion 34 c of the first bead component 34 a. The secondbead component 37 a positioned over the tubular portion of the specimenbag captures the specimen bag 21 between the two bead components 34 a,37 a thus coupling the bead 31 to the specimen bag 21. As such, in oneaspect, the capture ring 37 a encompasses a portion of the guide bead 31and a portion of the tissue bag 21 such that a portion of the tissue bagis positioned and thereby captured or secured between the capture ring37 a and the guide bead 31. Alternatively, the bead 31 in one aspectcould be a single component and the specimen bag bonded with an adhesiveto a portion of the bead 31, e.g., an exterior surface of thecylindrical portion 34 c of the bead 31.

The tissue retrieval device or system in one aspect comprises multiplecomponents. The introducer 3 is an extruded ABS (Acrylonitrile ButadieneStyrene) tube that has machined holes at its proximal end that engagepositioning pins on the upper handle and the lower handle to preventaxial and rotational movement of the tube relative to the handle 5. Theupper handle and the lower handle, that form handle 5, are injectionmolded with polycarbonate. The introducer 3 in one aspect is injectionmolded as a single component and in one aspect as two components. Theactuation rod 7 in one aspect comprises five components; an injectionmolded polycarbonate actuation rod, a molded EPDM (Ethylene PropyleneDiene Monomer) rubber O-ring, an injection molded polycarbonate supportcover, and two stamped 17-7 stainless steel support arms 23 a,b. AnO-ring fits into a receiving groove on the actuation rod 7 and serves toprevent loss of pneumoperitoneum through the system by sealing on theinside diameter of the introducer 3.

The support arms 23 a,b fit into recesses in the distal end of theactuation rod 7 and is trapped in place by the support cover, whichsnaps in place on the actuation rod 7. In various aspects a singlesupport arm is provided extending from the actuator 7 to support the bag21. In various aspects, a plurality of support arms is providedextending from the actuator 7 to support the bag 21. The specimen bag 21in one aspect is produced from a 0.004″ thick polyurethane film. A diecut pattern is produced from the film. Welding is conducted to createthe cuff portion 51 of the specimen bag 21. The cuff is formed byfolding over the top edge of the die cut pattern and an impulse typeheat sealer is used to create the cuff seam. Welding is conducted toform the final or desired shape of the bag 21. The film with the formedcuff is folded in half along its longitudinal axis such that the cuff ison the inside of the folded halves. An impulse type heat sealer is usedto weld and cut the specimen bag to produce the final or desiredconfiguration. The specimen bag sub-assembly in one aspect comprisesfive components; a specimen bag, a braided nylon cord loop, an injectionmolded polycarbonate bead, an injection molded capture ring, and aformed 302 stainless steel retaining ring. The cord 25 is fed throughthe cuff 51 on the specimen bag 21 and tied into a loop using a modifiedoverhand knot. The knot is positioned such that it is located towardsthe distal end of the specimen bag rim. The capture ring 37 a ispositioned over the cord loop 25 and over the tubular portion of thespecimen bag. The retaining ring 35 is pressed into position in a grooveon the bead. The cord loop 25 is fed through the central bore 39 on thebead 31. The tubular portion of the specimen bag 21 is fed over thedistal portion of the bead and the capture ring 37 a snap fitted overthe tubular portion of the specimen bag 21 to attach the bead 31 to thespecimen bag 21.

In one aspect, the O-ring is slid onto the actuation rod 7. The supportarms 23 a,b are fed through slots 38 on the bead 31 and into the cuffson the specimen bag 21. The support arms 23 a,b are nested into theactuation rod 7 and a support cover is press fitted into place. The cordloop 25 on the specimen bag 21 is run underneath the O-ring and slidthrough the holding slot on the actuation rod 7. The specimen bag 21 istightly rolled from the bottom to the top cuff portion of the specimenbag 21. The cord loop 25 is folded and laid into a receiving channel onthe actuation rod 7. The actuation rod 7 with the specimen bag 21 ispushed through the proximal end of the introducer 3 until the rolled upspecimen bag is flush with the distal end 3 a of the introducer 3. Theupper handle is positioned on the introducer 3 and the pawl 41 and pawlspring 43 are positioned on the upper handle. The pawl 41 is positionedsuch that its teeth are rotated clockwise relative to its neutral sixo'clock position. The lower handle is press fitted onto the upper handleto form handle 5.

In one aspect, in FIG. 18, the distal tip or end 3 a of the introducer 3is a tip 3 a′ formed such that the inside diameter of the tube would besmaller at its distal end 3 a as compared to the diameter along theremainder of the tube. The bead 31 is sized such that upon deployment ofthe specimen bag, the bead 31 dislodges from within the introducer 3,and abuts the tip formed end 3 a′ of the introducer 3 during the closingof the specimen bag 21 to assist in closing the specimen bag 21. Thedistal tip 3 a′ of the introducer 3 in one aspect also has one or morelongitudinal slots 61 to enable the tube to more readily expand as thecoiled or rolled specimen bag 21 is advanced through the introducertube.

In one aspect, the retaining ring 35 on the bead 31 is formed from anelastomeric material. In FIG. 19, in one aspect, the bead 31 has aramped portion 34 d which forces the diameter of the retaining ring 35to expand during the cinching or closing procedure of the specimen bag21 thereby preventing the bead 31 from being withdrawn into theintroducer 3. In one aspect, as shown in FIG. 20, the bead 31 hasexpanding arms 34 e which upon initial deployment of the specimen bag 21would abut the distal end 3 a of the introducer 3 to prevent the bead 31from being withdrawn into the introducer 3 facilitating the closing ofthe specimen bag 21. In FIG. 21, in one aspect, the introducer 3 has aseparate spring member 62 attached or disposed at the distal tip or end3 a and positioned and sized such that the spring member 62 or portionsthereof 62 a would protrude into the inside diameter of the introducer3. In one aspect, one or more spring arms with one or more projectionsor protrusions of spring member 62 are engaged into receivers such asholes, cavities and/or slots 69 in the introducer 3 and resilient flexoutward from the inner lumen of the introducer 3. The spring memberflexes allowing the coiled or rolled specimen bag 21 and the bead 31 topass through the introducer 3 during or prior to deployment of thespecimen bag 21, but remains in place preventing the bead 31 from beingwithdrawn into the introducer 3 after deployment of the specimen bag 21.As such, a resilient arm or spring member 62 is connected to theintroducer 3 and operationally engaging the guide bead 7. The arm isbeing movable in a first direction allowing movement of the guide bead31 in a distal direction and in a second direction preventing movementof the guide bead 31 in a proximal direction back into the introducer 3.

Referring now to FIG. 22, in one aspect, the introducer 3 is formed withone or more longitudinal slots 65 such that the bead 31 with one or moreprojections or protrusions 63 could be forced through the slot duringdeployment of the specimen bag 21 but is prevented from being withdrawnback into the introducer 3. As such, the introducer 3 in one aspect hasa slot 65 longitudinally extending along and/or through a portion of thedistal end. The guide bead 31 with a projection 63 engages the slot andis arranged to allow movement of the guide bead 31 in a distal directionand prevents movement of the guide bead 31 in a proximal direction backinto the introducer 3.

In FIGS. 23-25, in one aspect, the tissue retrieval device comprises anintermediate collar 67 that slides into a locking position at the distaltip or end 3 a of the introducer 3 during and/or after deployment of thespecimen bag 21. The collar 67 is positioned between the actuation rod 7and the bead 31. Once the collar 67 is locked in position, the collar 67prevents the bead 31 from being withdrawn back into the introducer 3. Inone aspect, the collar has a projection arranged to prevent movement ofthe guide bead in a proximal direction. For instance, the collar 67 inone aspect has one-way barbs 68 a to lock it in position. The collar 67in one aspect has a retaining ring 68 b to lock it in position. Thecollar 67 in one aspect has one or more spring arms 68 c that would moveoutward or portions thereof would engage into receivers such as holes,cavities and/or slots 69 in the introducer 3 to lock it in position.

In one aspect, the bead 31 is formed as one piece and the specimen bag21 bonded to the bead with an adhesive. The specimen bag 21 in oneaspect is attached to the bead by trapping the specimen bag between thebead and a small length of shrink tubing. In one aspect, as shown inFIG. 26, the bead 31 is molded in one piece with a living hinge 73 andthen folded in half to capture the specimen bag. The bead in one aspecthas capture posts 77 to capture the specimen bag 21 during folding ofthe bead. The bead also has a cord engagement groove 71 for securingthough allowing passage there through the cord loop 25.

The specimen or tissue retrieval device or system in general provides aneasy to use system that effectively contains excised tissue specimens,prevents loss or spillage of tissue specimens into a body cavity, andprotects the body wall access port site from contamination with theexcised tissue specimens during withdrawal of the tissue specimens fromwithin the body cavity. The tissue retrieval system in various aspectsinclude a ratcheting mechanism which ensures effective deployment andcinching of the specimen bag, a cord loop attached to the specimen bagwhich aids with withdrawal of the specimen bag through a body wall, abead attached to the specimen bag which serves as a dilator duringwithdrawal of the specimen bag to separate body wall muscle and tissuefibers, and a frictional lock on the bead which enables the specimen bagto be cinched closed and then re-opened as desired.

Although the present invention has been described in certain specificaspects, many additional modifications and variations would be apparentto those skilled in the art. It is therefore to be understood that thepresent invention may be practiced otherwise than specificallydescribed, including various changes in the size, shape and materials,without departing from the scope and spirit of the present invention.Thus, embodiments of the present invention should be considered in allrespects as illustrative and not restrictive.

1. (canceled)
 2. A tissue retrieval apparatus comprising: an introducertube having a longitudinally extending lumen; an actuator movablethrough the lumen of the introducer tube, the actuator having a proximalend and a distal end; a first support arm extending from the distal endof the actuator; a second support arm extending from the distal end ofthe actuator; and a third support arm extending from the distal end ofthe actuator a tissue bag having an open end and a closed end, the openend of the tissue bag releasably coupled to the first and second supportarms; a cord attached along a periphery of the open end of the tissuebag and to the actuator.
 3. The tissue retrieval apparatus of claim 2,wherein the tissue bag is movable from a stored position rolled withinthe introducer tube to a deployed position, and wherein in the deployedposition, the first and second support arms suspend and hold the tissuebag open at the open end.
 4. The tissue retrieval apparatus of claim 3,wherein the third support arm is releasably coupled to the tissue bagadjacent the closed end of the tissue bag and unrolls the tissue bagwhen the tissue bag is moved from the stored position to the deployedposition.
 5. The tissue retrieval apparatus of claim 2 wherein the thirdsupport arm is movable in a direction traverse to the first and secondsupport arms.
 6. The tissue retrieval apparatus of claim 2, wherein thethird support arm is positioned between the first and second supportarms.
 7. The tissue retrieval apparatus of claim 6, wherein the thirdsupport arm comprises a spring arm.
 8. The tissue retrieval apparatus ofclaim 2 wherein the third support arm is substantially shorter than thefirst and second arms.
 9. The tissue retrieval apparatus of claim 2,further comprising a guide bead frictionally coupled to the cord. 10.The tissue retrieval apparatus of claim 9, wherein first support arm,second support arm, and third support arm all extend through the guidebead.
 11. A tissue retrieval apparatus comprising: an introducer tubehaving a longitudinally extending lumen; an actuator movable through thelumen of the introducer tube, the actuator having a proximal end and adistal end; a tissue bag having an open end and a closed end, the openend of the tissue bag releasably coupled to the actuator; a cordattached along a periphery of the open end of the tissue bag and to theactuator; and a ratchet mechanism movable between a first position and asecond position such that with the ratchet mechanism in the firstposition, the ratchet mechanism allows movement of the actuator in adistal direction relative to the introducer tube and restricts movementof the actuator in a proximal direction relative to the introducer tube,and with the ratchet mechanism in the second position, the ratchetmechanism allows movement of the actuator in the proximal directionrelative to the introducer tube and restricts movement of the actuatorin the distal direction relative to the introducer tube.
 12. The tissueretrieval apparatus of claim 11, wherein the actuator is movabledistally relative to the introducer tube to deploy the tissue bag from astored position rolled within the introducer tube to a deployed positionextending distally from the introducer tube, and wherein the ratchetmechanism is in the first position when the tissue bag is in the storedposition.
 13. The tissue retrieval apparatus of claim 11, wherein theintroducer tube has a proximal end and a distal end, wherein theintroducer tube comprises a handle positioned at the proximal end of theintroducer tube, and wherein the ratchet mechanism comprises: a pawlpivotally connected to the handle; and a rack having a plurality ofteeth attached to the actuator and positioned to operationally engagethe pawl.
 14. The tissue retrieval apparatus of claim 13, wherein thepawl is biased to a neutral position and is pivotable between aclockwise-rotated position and a counterclockwise-rotated positionrelative to the neutral position.
 15. The tissue retrieval apparatus ofclaim 14, wherein the ratchet mechanism comprises a leaf spring biasingthe pawl to the neutral position.
 16. The tissue retrieval system ofclaim 14, wherein the rack further comprises a ramp formed on theactuator, the ramp positioned to allow the pawl to pivot to the neutralposition when the actuator has been moved distally to position thetissue bag in a deployed position.
 17. The tissue retrieval system ofclaim 13, wherein the handle comprises a stop engageable with theactuator to prevent the actuator from being fully withdrawn from thelumen of the introducer tube when the actuator has been moved proximallyto release the actuator from the tissue bag.
 18. The tissue retrievalapparatus of claim 11, wherein the ratchet mechanism is moved betweenthe first position and the second position responsive to movement of theactuator through the lumen.
 19. The tissue retrieval apparatus of claim18, wherein the actuator is movable distally relative to the introducertube to deploy the tissue bag from a stored position rolled within theintroducer tube to a deployed position extending distally from theintroducer tube, and wherein the ratchet mechanism is moved from thefirst position towards the second position when the tissue bag is movedto the deployed position.